An international research agenda for clozapine-resistant schizophrenia

Publikation: Bidrag til tidsskriftReviewForskningfagfællebedømt

  • Jurjen J Luykx
  • Jairo M Gonzalez-Diaz
  • Ta-Wei Guu
  • Marte Z van der Horst
  • Edwin van Dellen
  • Marco P Boks
  • Sinan Guloksuz
  • Lynn E DeLisi
  • Iris E Sommer
  • Russel Cummins
  • David Shiers
  • Jimmy Lee
  • Susanna Every-Palmer
  • Ahmed Mhalla
  • Zohra Chadly
  • Sherry K W Chan
  • Robert O Cotes
  • Shun Takahashi
  • Elias Wagner
  • Christoph U Correll
  • Alkomiet Hasan
  • Dan Siskind
  • Dominique Endres
  • James MacCabe
  • Jari Tiihonen

Treatment-resistant symptoms occur in about a third of patients with schizophrenia and are associated with a substantial reduction in their quality of life. The development of new treatment options for clozapine-resistant schizophrenia constitutes a crucial, unmet need in psychiatry. Additionally, an overview of past and possible future research avenues to optimise the early detection, diagnosis, and management of clozapine-resistant schizophrenia is unavailable. In this Health Policy, we discuss the ongoing challenges associated with clozapine-resistant schizophrenia faced by patients and health-care providers worldwide to improve the understanding of this condition. We then revisit several clozapine guidelines, the diagnostic tests and treatment options for clozapine-resistant schizophrenia, and currently applied research approaches in clozapine-resistant schizophrenia. We also suggest methodologies and targets for future research, divided into innovative nosology-oriented field trials (eg, examining dimensional symptom staging), translational approaches (eg, genetics), epidemiological research (eg, real-world studies), and interventional studies (eg, non-traditional trial designs incorporating lived experiences and caregivers' perspectives). Finally, we note that low-income and middle-income countries are under-represented in studies on clozapine-resistant schizophrenia and propose an agenda to guide multinational research on the cause and treatment of clozapine-resistant schizophrenia. We hope that this research agenda will empower better global representation of patients living with clozapine-resistant schizophrenia and ultimately improve their functional outcomes and quality of life.

OriginalsprogEngelsk
TidsskriftThe lancet. Psychiatry
Vol/bind10
Udgave nummer8
Sider (fra-til)644-652
ISSN2215-0366
DOI
StatusUdgivet - 2023

Bibliografisk note

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